Clenching

Clenching is often one of the symptoms of Temporomandibular Joint Dysfunction.

The Temporomandibular Joint (TMJ) is the joint connecting the lower jaw and skull, which enables you to open and close the mouth, and chew from side to side. Temporomandibular Joint Dysfunction (TMD) is the name given to problems with the jaw, and the muscles in the face that control it.

At Shields Dental & Implant Clinic Limerick, we have years of experience in the diagnosis and treatment of TMD and have been members of the British Society for Occlusal Studies for over 10 years.

Here are some key points and questions about Clenching and TMD that you should be aware of:

Clenching the jaw is something that most people tend to do when focusing on a domestic or work task such as household chores, gardening, car maintenance, typing, and so on.

However, excessive clenching can lead to severe headaches or neck and shoulder pain, or you may suffer from recurrent pain or discomfort on the side of the face around the ears or the jaw joints.

‘Occlusion’ is the dental term used to describe the way the teeth meet when the jaws bite together.

If the teeth do not fit together properly, this can create problems not only for the teeth but also the gums, the temporomandibular joint and the muscles that control it. Occlusal problems manifest themselves in a number of different areas. Among the signs are:
  • Clicking, grinding or pain in the jaw joints; ringing or buzzing in the ears; and difficulty opening or closing the mouth.
  • Teeth that are out of line, heavily worn or constantly breaking, fillings that fracture, or crowns that work loose.
  • Loose teeth or receding gums, which can be worsened by a faulty ‘bite’.
  • Muscle spasm: if the jaw is in the wrong position, the muscles moving the jaw must work harder and so tire, leading to muscle spasm, which causes headaches or migraine, especially first thing in the morning; pain behind the eyes; sinus pain; pains in the neck and shoulders; and, occasionally, discomfort in the back muscles.

Up to 1 in 4 people, men and women equally, may have some symptoms. The symptoms can often start with the menopause or other hormonal changes. Many people have imperfect occlusion and missing teeth, yet never have symptoms because they adjust to their problems. Occasionally, in times of increased stress and tension, the symptoms may appear and then go away immediately.

In some cases, the teeth and gums can be affected straight away and, instead of headaches, you may suffer:

  • Flattened, worn teeth
  • Broken teeth, fillings and crowns
  • Loose teeth
  • Continual sensitivity of your teeth to temperature change
  • Toothache with no apparent cause

Conor and Cormac have undertaken extensive postgraduate training with the British Society of Occlusal Studies and are experienced in the assessment and treatment of TMD.

Various muscles may be sore when testing, or broken and worn areas of the teeth can provide tell-tale evidence of clenching or grinding, a common sign of an incorrect bite.

The dentist may diagnose the problem by prescribing an Occlusal Splint, a hard plastic appliance that fits over the upper or lower teeth. This will be measured and fitted accurately so that when you bite on it, when your muscles are relaxed, all your teeth meet at exactly the same time.

The Occlusal Splint may have to be worn all the time, or at night only. If the appliance relieves the symptoms, it is possible that your bite will need permanent correction.

Your teeth may need to be carefully adjusted to meet evenly. Changing the direction and position of the slopes that guide your teeth together can often help to reposition the jaw.

The temporomandibular joint needs equal support from both sides of both jaws. Missing teeth may need to be replaced by tooth replacement therapy using bridges, dentures, or implants. Replacement is not usually done until a diagnosis is confirmed using an Occlusal Splint that has relieved the symptoms. Relief for some patients is instant. For others it can take a long time.